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General NPI Number Information
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NPI Number | 1477365468
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Entity Type | Individual
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Provider Name | MR. ABU-DAWUD ALI
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Gender | Male
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Dates
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Enumeration Date | 01/25/2025
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Last Update Date | 01/25/2025
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Provider Practice Location Address
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Address Line | 114 BERGEN AVE
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City | WALDWICK
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State | NJ
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Zip | 07463-2111
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Country | US
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Telephone | 833-786-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 60 HOWARD DR APT K
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City | BERGENFIELD
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State | NJ
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Zip | 07621-4519
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Country | US
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Telephone | 347-244-6426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT01128100
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License Number State | NJ
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